162 - Smoke Elimination Begins with Smoke Evacuation: Providing the Highest Quality Healthcare for America’s Heroes
Description: CLINICAL ISSUE • Surgical smoke (plume) is generated by a variety of energy producing equipment used regularly in the peri operative environment including electrosurgicaI units, lasers, ultrasonic devices and power tools. • Documented evidence of the harmful effects of surgical smoke is prevalent in literature and recommendations for reducing the risk of harm to patients and health care workers have been published by organizations such as the AORN, Joint Commission, ANSI, and NIOSH. • In the absence of consistent and effective management, surgical smoke continues to permeate the perioperative environment potentially causing harm to patients and personnel. Based upon this information, it was determined an educational initiative was needed to increase perioperative staff’s awareness of the harmful effects of surgical smoke. PREPARATION AND PLANNING • A literature search was conducted – seven articles were felt to contain key evidence and were used in the development of educational material for staff. Relevant AORN Recommended Practice Statements and the AORN Surgical Smoke Management Toolkit were reviewed. • Proposed Standard Operating Procedure in order to be consistent with "best practices". PERFORMANCE IMPROVEMENT
Method: ASSESS, IMPROVE, IMPLEMENT, MEASURE ASSESS: Existing practice for managing surgical smoke in the perioperative environment was assessed: • Utilization data demonstrated that surgical smoke evacuation had been used less in most recent three month period. IMPROVE: Established the overall project goals: • Improve staff knowledge related to the following areas: how surgical smoke (plume) is generated, the contents of surgical smoke (plume) and its harmful effects, "best practice” interventions for minimizing surgical smoke in the environment and mitigating its harmful effects to patients, operating room personnel and surgical team members. • Ensure immediate availability of appropriate surgical smoke management equipment and supplies to improve compliance. Surgeon preference cards and OR substerile areas were updated with appropriate smoke evacuation equipment and supplies, and staff was provided with key information facts on hazards of surgical smoke and location of surgical smoke equipment. IMPLEMENT: Developed and implemented a 3-part multi-media education program: OUTCOME/MEASUREMENT: • Surgical Smoke Management supply usage during the six month period following implementation of the education program increased significantly. ADDITIONAL SUCCESS STRATEGIES • Project is on-going and will continue to track usage data and refine strategies for success. • Shift focus to education of other surgical team members, including physicians, residents, physician assistants, Medical Students and others. • Series of educational posters are hung at scrub sinks and changed every two weeks. • A Program was developed that rewarded employees found using surgical smoke management equipment during random visit. • Periodically meet with surgical service team leaders to discuss specific physician preferences and possible barriers to success, look for solutions to specific requirements. Working with Material Resource Center staff to identify possible cost-effective solutions to physician or procedure-driven unique surgical smoke management requirements.